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Högberg, B., Strandh, M., Johansson, K. & Petersen, S. (2023). Trends in adolescent psychosomatic complaints: a quantile regression analysis of Swedish HBSC data 1985–2017. Scandinavian Journal of Public Health, 51, 619-624
Open this publication in new window or tab >>Trends in adolescent psychosomatic complaints: a quantile regression analysis of Swedish HBSC data 1985–2017
2023 (English)In: Scandinavian Journal of Public Health, ISSN 1403-4948, E-ISSN 1651-1905, Vol. 51, p. 619-624Article in journal (Refereed) Published
Abstract [en]

Background and aims: According to recent criticism, survey-based measures of adolescent psychosomatic complaints have poor content validity insofar as they conflate trivial with severe complaints. It is argued that this means that estimates of prevalence and trends in complaints may reflect trivial complaints that are not indicators of health problems. In this study, two observable implications of this criticism were investigated: (a) that self-reported psychosomatic complaints should have a bimodal distribution; and (b) that the increase in complaints over time should be of approximately equal size throughout the distribution of complaints.

Methods: Three decades (1985/1986–2017/2018) of repeated cross-sectional data from the Swedish Health Behaviour in School-aged Children survey were used. Psychosomatic complaints were measured using the screening instrument Health Behaviour in School-aged Children symptom checklist. Histograms, bar charts and quantile regression models were used for the analysis.

Results and conclusions: With regard to the first implication, the results showed that the distribution of complaints was not bimodal and that there were no clusters of respondents. This suggests that binary categorisations of students can be reductive and conceal important variations across students. With regard to the second implication, the results showed that the increase in complaints was greatest among students who report frequent and co-occurring complaints. This suggests that reports of increasing complaints in adolescents cannot be explained as being primarily due to a greater inclination to report trivial complaints. It is concluded that any conflation of trivial and more severe complaints in surveys of psychosomatic complaints is not reflected in population-based estimates.

Place, publisher, year, edition, pages
Sage Publications, 2023
Keywords
Adolescents, children, health complaints, psychosomatic, mental health, temporal trends, HBSC, Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Research subject
Public health
Identifiers
urn:nbn:se:umu:diva-194508 (URN)10.1177/14034948221094497 (DOI)000796285200001 ()2-s2.0-85132638212 (Scopus ID)
Funder
Swedish Research Council, 2018–03870_3Forte, Swedish Research Council for Health, Working Life and Welfare, 2015-00048
Available from: 2022-05-08 Created: 2022-05-08 Last updated: 2023-07-14Bibliographically approved
Ragnarsson, S., Johansson, K., Bergström, E., Sjöberg, G., Hurtig, A.-K. & Petersen, S. (2022). Recurrent pain in school-aged children: a longitudinal study focusing on the relation to academic achievement. Pain, 163(11), 2245-2253
Open this publication in new window or tab >>Recurrent pain in school-aged children: a longitudinal study focusing on the relation to academic achievement
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2022 (English)In: Pain, ISSN 0304-3959, E-ISSN 1872-6623, Vol. 163, no 11, p. 2245-2253Article in journal (Refereed) Published
Abstract [en]

Recurrent pain is an increasing public health problem among school-aged children, with potential negative impact on children's daily lives, such as schoolwork. The overall aim of this study was to investigate whether recurrent pain in school year 6 was associated with poorer academic achievement at the end of elementary school in school year 9. The study was a follow-up study based on data from "The Study of Health in School-Aged Children from Umeå". Participants were 1567 children aged 12 to 13 years who attended school year 6. A follow-up was performed in school year 9, when the children were 16 years old. The children answered a questionnaire about recurrent pain (headache, stomachache, and backache). Information about academic achievement was collected from school registers. The results showed that having weekly recurrent pain in school year 6 predicted lower final overall grade points in school year 9 than in children with no recurrent pain. This applied for recurrent headache, stomachache, backache, and multiple pains and for both girls and boys. Recurrent pain did not predict secondary school eligibility, however. Perceived problems with academic achievement and problems with concentration partly mediated the association between recurrent pain and lower final overall grade points. Sleep problems were not associated with academic achievement and were therefore not a mediator. Thus, the results suggest that recurrent pain may predict later impairment of academic achievement and that problems with concentration and children's perceived achievement in school, but not sleep problems, may partly explain this relationship.

Place, publisher, year, edition, pages
Lippincott Williams & Wilkins, 2022
National Category
Public Health, Global Health, Social Medicine and Epidemiology Nursing
Identifiers
urn:nbn:se:umu:diva-195606 (URN)10.1097/j.pain.0000000000002625 (DOI)000868828900021 ()35250010 (PubMedID)2-s2.0-85140273237 (Scopus ID)
Funder
Region VästerbottenUmeå municipalityStiftelsen drottning Silvias jubileumsfond
Available from: 2022-06-01 Created: 2022-06-01 Last updated: 2022-11-07Bibliographically approved
Högberg, B., Lindgren, J., Johansson, K., Strandh, M. & Petersen, S. (2021). Consequences of school grading systems on adolescent health: evidence from a Swedish school reform. Journal of education policy, 36(1), 84-106
Open this publication in new window or tab >>Consequences of school grading systems on adolescent health: evidence from a Swedish school reform
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2021 (English)In: Journal of education policy, ISSN 0268-0939, E-ISSN 1464-5106, Vol. 36, no 1, p. 84-106Article in journal (Refereed) Published
Abstract [en]

Education reforms that entail increased emphasis on high-stakes testing, assessment and grading have spread across education systems in recent decades. Critics have argued that these policies could have consequences for stress, identity, self-esteem and the overall health of pupils. However, these potentially negative consequences have rarely been investigated in a systematic and rigorous way. In this study we use a major education reform in Sweden, which introduced grades and increased the use of testing for pupils in the 6th and 7th school year (aged 12 to 13 years), to study the consequences of grading and assessment for health outcomes. Using data from the Health Behaviours of School-Aged Children Survey, we find that the reform increased school-related stress and reduced the academic self-esteem of pupils in the 7th school year. This, in turn, had an indirect effect on psychosomatic symptoms and life satisfaction for these pupils. Moreover, the negative effects of the reform were generally stronger for girls, thereby widening the already troubling gender differences in health. We conclude that accountability reforms aimed at increased use of testing, assessment and grading can potentially have negative side effects on pupils’ health.

Place, publisher, year, edition, pages
Routledge, 2021
Keywords
Stress, health, grading, accountability, education reform, gender
National Category
Educational Sciences Social Work
Identifiers
urn:nbn:se:umu:diva-165211 (URN)10.1080/02680939.2019.1686540 (DOI)000493743800001 ()2-s2.0-85074555659 (Scopus ID)
Available from: 2019-11-15 Created: 2019-11-15 Last updated: 2021-03-29Bibliographically approved
Högberg, B., Petersen, S., Strandh, M. & Johansson, K. (2021). Determinants of Declining School Belonging 2000–2018: The Case of Sweden. Social Indicators Research, 157(2), 783-802
Open this publication in new window or tab >>Determinants of Declining School Belonging 2000–2018: The Case of Sweden
2021 (English)In: Social Indicators Research, ISSN 0303-8300, E-ISSN 1573-0921, Vol. 157, no 2, p. 783-802Article in journal (Refereed) Published
Abstract [en]

Students' sense of belonging at school has declined across the world in recent decades, and more so in Sweden than in almost any other high-income country. However, we do not know the characteristics or causes of these worldwide trends. Using data on Swedish students aged 15–16 years from the Programme for International Student Assessment (PISA) between 2000 and 2018, we show that the decline in school belonging in Sweden was driven by a disproportionately large decline at the bottom part of the distribution, and was greatest for foreign-born students, students from disadvantaged social backgrounds, and for low-achieving students. The decline cannot be accounted for by changes in student demographics or observable characteristics related to the school environment. The decline did, however, coincide with a major education reform, characterized by an increased use of summative evaluation, and an overall stronger performance-orientation.

Place, publisher, year, edition, pages
Springer, 2021
Keywords
School belonging, School connectedness, Adolescence, Temporal trends, School environment
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-181599 (URN)10.1007/s11205-021-02662-2 (DOI)000627696800001 ()2-s2.0-85102503831 (Scopus ID)
Funder
Swedish Research Council, 2018–03870_3Forte, Swedish Research Council for Health, Working Life and Welfare, 2015-00048
Available from: 2021-03-18 Created: 2021-03-18 Last updated: 2021-12-29Bibliographically approved
Lindvall, K., Vaezghasemi, M., Feldman, I., Ivarsson, A., Stevens, K. J. & Petersen, S. (2021). Feasibility, reliability and validity of the health-related quality of life instrument Child Health Utility 9D (CHU9D) among school-aged children and adolescents in Sweden. Health and Quality of Life Outcomes, 19(1), Article ID 193.
Open this publication in new window or tab >>Feasibility, reliability and validity of the health-related quality of life instrument Child Health Utility 9D (CHU9D) among school-aged children and adolescents in Sweden
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2021 (English)In: Health and Quality of Life Outcomes, ISSN 1477-7525, E-ISSN 1477-7525, Vol. 19, no 1, article id 193Article in journal (Refereed) Published
Abstract [en]

Background: This study was conducted in a general population of schoolchildren in Sweden, with the aim to assess the psychometric properties of a generic preference-based health related quality of life (HRQoL) instrument, the Swedish Child Health Utility 9D (CHU9D), among schoolchildren aged 7–15 years, and in subgroups aged 7–9, 10–12 and 13–15 years.

Methods: In total, 486 school aged children, aged 7–15 years, completed a questionnaire including the CHU9D, the Pediatric quality of life inventory 4.0 (PedsQL), KIDSCREEN-10, questions on general health, long-term illness, and sociodemographic characteristics. Psychometric testing was undertaken of feasibility, internal consistency reliability, test–retest reliability, construct validity, factorial validity, concurrent validity, convergent validity and divergent validity.

Results: The CHU9D evidenced very few missing values, minimal ceiling, and no floor effects. The instrument achieved satisfactory internal consistency (Cronbach’s Alfa > 0.7) and strong test–retest reliability (r > 0.6). Confirmatory factor analyses supported the proposed one-factor structure of the CHU9D. For child algorithm, RMSEA = 0.05, CFI = 0.95, TLI = 0.94, and SRMR = 0.04. For adult algorithm RMSEA = 0.04, CFI = 0.96, TLI = 0.95, and SRMR = 0.04. The CHU9D utility value correlated moderately or strongly with KIDSCREEN-10 and PedsQL total scores (r > 0.5–0.7). The CHU9D discriminated as anticipated on health and on three of five sociodemographic characteristics (sex, age, and custody arrangement, but not socioeconomic status and ethnic origin).

Conclusions: This study provides evidence that the Swedish CHU9D is a feasible, reliable and valid measure of preference-based HRQoL in children. The study furthermore suggests that the CHU9D is appropriate for use among children 7–15 years of age in the general population, as well as among subgroups aged 7– 9, 10–12 and 13–15 years.

Place, publisher, year, edition, pages
BioMed Central, 2021
Keywords
Adolescent, Child, CHU9D, Health related quality of life, HRQoL, Psychometrics, Sweden
National Category
Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-186637 (URN)10.1186/s12955-021-01830-9 (DOI)000683730500003 ()34344386 (PubMedID)2-s2.0-85112016482 (Scopus ID)
Available from: 2021-08-30 Created: 2021-08-30 Last updated: 2023-03-24Bibliographically approved
Bortes, C., Ragnarsson, S., Strandh, M. & Petersen, S. (2021). The Bidirectional Relationship Between Subjective Well-Being and Academic Achievement in Adolescence. Journal of Youth and Adolescence, 50(5), 992-1002
Open this publication in new window or tab >>The Bidirectional Relationship Between Subjective Well-Being and Academic Achievement in Adolescence
2021 (English)In: Journal of Youth and Adolescence, ISSN 0047-2891, E-ISSN 1573-6601, Vol. 50, no 5, p. 992-1002Article in journal (Refereed) Published
Abstract [en]

The well-being of young people in relation to their school performance has received increased attention in recent years. However, there is a lack of knowledge about the longitudinal and reciprocal relationship between adolescents’ subjective well-being and their academic achievements. The current study examined the bidirectional relationship between subjective well-being and academic achievement across two timepoints (T1 and T2) during the course of mid to late adolescence, i.e.,in school year 9 (age 15), and school years 11–12 (ages 17–18). The study also investigated variation in the association as afunction of adolescent gender. Data on subjective well-being and teacher-assigned school grades of 723 adolescents (48.7% girls) residing in Sweden were analyzed by estimating a series of cross-lagged path models. The findings suggest gender differences in the relationship as no associations were found among boys. Support for a bidirectional relationship between the constructs was only found for girls. For girls, higher subjective well-being at T1 was associated with higher academic achievements at T2, while higher academic achievements at T1 was associated with lower subjective well-being at T2. These findings highlight that the subjective well-being of adolescent girls may be important for their ability to perform at school, but their academic achievements may also inflict negatively on their subjective well-being.

Place, publisher, year, edition, pages
Springer, 2021
Keywords
Academic achievement, Bidirectional associations, Cross-lagged panel analysis, Gender differences, Subjective well-being
National Category
Social Work
Identifiers
urn:nbn:se:umu:diva-181178 (URN)10.1007/s10964-021-01413-3 (DOI)000625716600002 ()33675505 (PubMedID)2-s2.0-85102262367 (Scopus ID)
Funder
Swedish Research Council, 2014-1992Marianne and Marcus Wallenberg Foundation, 2014.0154Region Västerbotten
Available from: 2021-03-06 Created: 2021-03-06 Last updated: 2021-06-11Bibliographically approved
Le, H. N. D., Petersen, S., Mensah, F., Gold, L., Wake, M. & Reilly, S. (2020). Health-Related Quality of Life in Children With Low Language or Congenital Hearing Loss, as Measured by the PedsQL and Health Utility Index Mark 3. Value in Health, 23(2), 164-170
Open this publication in new window or tab >>Health-Related Quality of Life in Children With Low Language or Congenital Hearing Loss, as Measured by the PedsQL and Health Utility Index Mark 3
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2020 (English)In: Value in Health, ISSN 1098-3015, E-ISSN 1524-4733, Vol. 23, no 2, p. 164-170Article in journal (Refereed) Published
Abstract [en]

Objectives: To examine health-related quality of life (HRQoL) in young children with low language or congenital hearing loss and to explore the value of assessing HRQoL by concurrently administering 2 HRQoL instruments in populations of children.

Methods: Data were from 2 Australian community-based studies: Language for Learning (children with typical and low language at age 4 years, n = 1012) and the Statewide Comparison of Outcomes study (children with hearing loss, n = 108). HRQoL was measured using the parent-reported Health Utilities Index Mark 3 (HUI3) and the Pediatrics Quality of Life Inventory 4.0 (PedsQL) generic core scale. Agreement between the HRQoL instruments was assessed using intraclass correlation and Bland-Altman plots.

Results: Children with low language and with hearing loss had lower HRQoL than children with normal language; the worst HRQoL was experienced by children with both. The lower HRQoL was mainly due to impaired school functioning (PedsQL) and speech and cognition (HUI3). Children with hearing loss also had impaired physical and social functioning (PedsQL), vision, hearing, dexterity, and ambulation (HUI3). Correlations between instruments were poor to moderate, with low agreement.

Conclusions: Children with low language and congenital hearing loss might benefit from interventions targeting overall health and well-being, not just their impairments. The HUI3 and PedsQL each seemed to provide unique information and thus may supplement each other in assessing HRQoL of young children, including those with low language or congenital hearing loss.

Place, publisher, year, edition, pages
Elsevier, 2020
Keywords
children, health-related quality of life, low language and hearing loss
National Category
Nursing
Identifiers
urn:nbn:se:umu:diva-169089 (URN)10.1016/j.jval.2019.07.019 (DOI)000517813500005 ()32113621 (PubMedID)2-s2.0-85073062774 (Scopus ID)
Available from: 2020-03-23 Created: 2020-03-23 Last updated: 2023-03-23Bibliographically approved
Petersen, S. & Romqvist, A. (2020). När skolan lär barn om psykisk hälsa minskar inåtvända psykiska problem bland barnen: En kartläggning av systematiska litteraturöversikter. Socialmedicinsk Tidskrift, 97(5-6), 832-846
Open this publication in new window or tab >>När skolan lär barn om psykisk hälsa minskar inåtvända psykiska problem bland barnen: En kartläggning av systematiska litteraturöversikter
2020 (Swedish)In: Socialmedicinsk Tidskrift, ISSN 0037-833X, Vol. 97, no 5-6, p. 832-846Article in journal (Other academic) Published
Abstract [sv]

Inåtvända psykiska problem såsom ångest och nedstämdhet är vanliga bland barn i skolåldern. I en kartläggning av systematiska litteraturöversikter har vi studerat skolans betydelse för förekomsten av sådana problem. Ett delresultat visar att inåtvända psykiska problem minskar när skolan lär barnen om psykisk hälsa och hur de kan hantera sin och andras psykiska hälsa.De positiva effekterna ses i alla åldrar från lågstadiet till gymnasiet och vidbåde universella insatser till alla barn och riktade insatser till barn som har ökad risk att utveckla psykiska problem eller redan har symtom. Effekten verkar dock minska över tid. Det är därför intressant att vidare utreda om fortlöpande insatser kan ge mer hållbara effekter. Sammantaget visar resultaten att skolan kan bidra till minskade inåtvända psykiska problem genom att lära barn om psykisk hälsa och hur den kan hanteras.  

Abstract [en]

Internalizing problems such as anxiety and depressive symptoms are com-mon among school-ages children. To study school-related determinants ofsuch problems, we performed a scoping review of systematic literature re-views. One result from the scoping review was that school-based activities aiming to enhance mental health knowledge and management can decrease internalizing problems in school-aged children. The effect is similar in young-er and older school-aged children, and it is seen in both universal interven-tions to all children and interventions targeting children with an increased risk of developing internalizing problems or already having such problems.The effect, however, decreases over time, making further investigations of continuous or repeated knowledge-enhancing activities interesting. Taking together, the results show that schools can contribute to the decrease of internalizing problems by teaching children about mental health and mental health management.

Place, publisher, year, edition, pages
Stockholm: Karolinska Institutet, 2020
Keywords
Depression, effekt, psykosomatiska problem, tonåringar, unga, ångest
National Category
Psychiatry Public Health, Global Health, Social Medicine and Epidemiology
Identifiers
urn:nbn:se:umu:diva-178440 (URN)
Available from: 2021-01-12 Created: 2021-01-12 Last updated: 2021-03-29Bibliographically approved
Ragnarsson, S., Myléus, A., Hurtig, A.-K., Sjöberg, G., Rosvall, P.-Å. & Petersen, S. (2020). Recurrent Pain and Academic Achievement in School-Aged Children: A Systematic Review. Journal of School Nursing, 36(1), 61-78
Open this publication in new window or tab >>Recurrent Pain and Academic Achievement in School-Aged Children: A Systematic Review
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2020 (English)In: Journal of School Nursing, ISSN 1059-8405, E-ISSN 1546-8364, Vol. 36, no 1, p. 61-78Article, review/survey (Refereed) Published
Abstract [en]

Recurrent pain and school failures are common problems in children visiting the school nurses office. The overall aim of the current study was to investigate the relationship between recurrent pain and academic achievement in school-aged children. Literature was searched in seven electronic databases and in relevant bibliographies. Study selection, data extraction, and study and evidence quality assessments were performed systematically with standardized tools. Twenty-one studies met the inclusion criteria and 13 verified an association between recurrent pain (headache, stomachache, and musculoskeletal pain) and negative academic achievement. Two longitudinal studies indicated a likely causal effect of pain on academic achievement. All studies had substantial methodological drawbacks and the overall quality of the evidence for the identified associations was low. Thus, children’s lack of success in school may be partly attributed to recurrent pain problems. However, more highquality studies are needed, including on the direction of the association and its moderators and mediators.

Place, publisher, year, edition, pages
Sage Publications, 2020
Keywords
recurrent pain, school-aged children, school failure, school nursing
National Category
Nursing Public Health, Global Health, Social Medicine and Epidemiology Learning
Identifiers
urn:nbn:se:umu:diva-157030 (URN)10.1177/1059840519828057 (DOI)000506536900007 ()2-s2.0-85062030498 (Scopus ID)
Available from: 2019-03-06 Created: 2019-03-06 Last updated: 2023-03-24Bibliographically approved
Andermo, S., Hallgren, M., Nguyen, T.-T., Jonsson, S., Petersen, S., Friberg, M., . . . Elinder, L. S. (2020). School-related physical activity interventions and mental health among children: a systematic review and meta-analysis.. Sports medicine - open, 6(1), Article ID 25.
Open this publication in new window or tab >>School-related physical activity interventions and mental health among children: a systematic review and meta-analysis.
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2020 (English)In: Sports medicine - open, ISSN 2199-1170, Vol. 6, no 1, article id 25Article in journal (Refereed) Published
Abstract [en]

BACKGROUND: Low levels of physical activity, sedentary behaviour and mental health problems are issues that have received considerable attention in the last decade. The aim of this systematic review and meta-analysis was to investigate effects of interventions targeting school-related physical activity or sedentary behaviour on mental health in children and adolescents and to identify the features of effective interventions.

METHODS: Scientific articles published between January 2009 and October 2019 fulfilling the following criteria were included: general populations of children and adolescents between age 4 and 19, all types of school-related efforts to promote physical activity or reduce sedentary behaviour. Study selection, data extraction and quality assessment were done by at least two authors independently of each other. Data were analysed with a random effects meta-analysis and by narrative moderator analyses.

RESULTS: The literature search resulted in 10265 unique articles. Thirty-one articles, describing 30 interventions, were finally included. Eleven relevant outcomes were identified: health-related quality of life, well-being, self-esteem and self-worth, resilience, positive effect, positive mental health, anxiety, depression, emotional problems, negative effect and internalising mental health problems. There was a significant beneficial effect of school-related physical activity interventions on resilience (Hedges' g = 0.748, 95% CI = 0.326; 1.170, p = 0.001), positive mental health (Hedges' g = 0.405, 95% CI = 0.208; 0.603, p = < 0.001), well-being (Hedges' g = 0.877, 95% CI = 0.356; 1.398, p = < 0.001) and anxiety (Hedges' g = 0.347, 95% CI = 0.072; 0.623, p = 0.013). Heterogeneity was moderate to high (I2 = 59-98%) between studies for all outcomes except positive effect, where heterogeneity was low (I2 = 2%). The narrative moderator analyses of outcomes based on 10 or more studies showed that age of the children moderated the effect of the intervention on internalising mental health problems. Interventions in younger children showed a significantly negative or no effect on internalising mental health problems while those in older children showed a significant positive or no effect. Moreover, studies with a high implementation reach showed a significant negative or no effect while those with a low level of implementation showed no or a positive effect. No signs of effect moderation were found for self-esteem, well-being or positive mental health. Risk of publication bias was evident for several outcomes, but adjustment did not change the results.

CONCLUSIONS: School-related physical activity interventions may reduce anxiety, increase resilience, improve well-being and increase positive mental health in children and adolescents. Considering the positive effects of physical activity on health in general, these findings may reinforce school-based initiatives to increase physical activity. However, the studies show considerable heterogeneity. The results should therefore be interpreted with caution. Future studies should report on implementation factors and more clearly describe the activities of the control group and whether the activity is added to or replacing ordinary physical education lessons in order to aid interpretation of results.

TRIAL REGISTRATION: PROSPERO, CRD42018086757.

Keywords
Children, Mental health, Meta-analysis, Physical activity, School-related, Systematic review
National Category
Public Health, Global Health, Social Medicine and Epidemiology Pediatrics
Identifiers
urn:nbn:se:umu:diva-177287 (URN)10.1186/s40798-020-00254-x (DOI)000546853400001 ()32548792 (PubMedID)
Funder
Public Health Agency of Sweden , 04287-2017Public Health Agency of Sweden , 05031-2018
Available from: 2020-12-04 Created: 2020-12-04 Last updated: 2021-03-29Bibliographically approved
Organisations
Identifiers
ORCID iD: ORCID iD iconorcid.org/0000-0001-6720-2430

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